Initial Fitting

1. Start with a same-day spectacle Rx for all new and refit patients.
   • Add +0.25D to the most plus vertex-corrected, spherical equivalent Rx for each eye to determine sphere 
   • Add power based on lowest acceptable add:
   • Up to 1.25 ADD = LO
   • +1.50 to +2.00 ADD = MED
   • +2.25 to +2.50 ADD = HI
2.  ALLOW FOR 5-10 MINUTES of real-world exposure outside the exam room before assessing visual performance. Have the patient look outside and use their digital device while they are waiting.
3. With both eyes open, use hand-held lenses on each eye separately, by adding plus in 0.25D steps until the patient reports a decline in distance vision.
4. Verify over-refraction binocularly by having the patient look at distance and near objects
   through the hand-held lenses.
5. Keeping the ADD the same, apply new trial lenses based on the over-refraction results. If the patient’s vision is functional, dispense trial lenses for 5-7 days and schedule a follow-up visit.